Interventions to increase participation in lung cancer screening programmes: a systematic review and meta-analysis.
Olivera Djuric, Andrea Guida, Francesca Bononi et al.
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In 30 seconds
This systematic review and meta-analysis assessed interventions to improve informed choice and participation in low-dose CT lung cancer screening. It included randomised and nonrandomised controlled trials and before-after studies; 14 completed and 21 ongoing studies were identified. Compared with control groups, shared decision-making plus navigation was associated with higher screening completion (OR 4.34, 95% CI 2.50-7.54), as was outreach plus navigation (OR 2.20, 95% CI 1.70-2.84). The authors judged the evidence to be of low certainty and identified combined, high-intensity patient-oriented approaches as the most promising.
Key findings
- Shared decision-making plus navigation was associated with greater LDCT completion than control (OR 4.34, 95% CI 2.50-7.54).
- Outreach plus navigation increased LDCT completion compared with control (OR 2.20, 95% CI 1.70-2.84).
- Multicomponent interventions improved uptake (OR 2.64, 95% CI 1.79-3.90), whereas unicomponent interventions did not (OR 1.00, 95% CI 0.87-1.14).
- Educational/informational interventions and shared decision-making alone did not improve LDCT uptake.
Why it matters
Screening participation depends not only on offering LDCT but also on supporting people through decisions and access. The findings suggest that navigation combined with outreach or shared decision-making may address barriers more effectively than information or decision support alone. However, low-certainty evidence means the comparative benefits remain uncertain, and the review highlights limited evaluation of provider- and system-level approaches.
What to keep in mind
The authors rate the evidence as low certainty. The review also found that community-based, provider-level and system-level interventions were rare, limiting evidence about these approaches.